Aerodynamic, Acoustic, and Vibratory Comparison of Arytenoid Adduction and Adduction Arytenopexy
Identifieur interne : 000E68 ( Istex/Corpus ); précédent : 000E67; suivant : 000E69Aerodynamic, Acoustic, and Vibratory Comparison of Arytenoid Adduction and Adduction Arytenopexy
Auteurs : Justin Mcnamar ; Douglas W. Montequin ; Nathan V. Welham ; Seth H. DaileySource :
- The Laryngoscope [ 0023-852X ] ; 2008-03.
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- KwdEn :
Abstract
Hypothesis: Adduction arytenopexy (AP) with thyroplasty provides improved physiologic placement of the vocal fold and therefore provides improved acoustic, aerodynamic, and vibratory function as compared with arytenoid adduction (AA) with thyroplasty. Methods: Five cadaveric human larynges were prepared by removing supraglottic tissues and fixing the nontest vocal fold medially on the cricoid facet with a needle in a physiologic phonating position. Each test vocal fold was then sequentially tested using an excised larynx phonation system, first with AA with silastic medialization and then converted to AP without changing the contralateral fold position or silastic wedge. The excised larynx setup allowed for simultaneous collection of data, specifically subglottic pressure (including measurement of phonation threshold pressure [PTP]), mean airflow, acoustic output, and full‐frame high‐speed digital video. Results: Aerodynamic evaluation was similar for each group with similar subglottic pressure versus output curves. Conditions involving AP typically had PTP values that were 80% of that for comparable AA conditions. Acoustic evaluation revealed differences between the two groups. Each AA was found to be vibrating with two dominant frequencies with their associated harmonics. Each AP vibrated at a single dominant frequency with its harmonics. Conclusion: AP provides improved vocal outcomes by decreasing system noise and decreasing PTP, which may lead to a stronger glottal signal with decreased vocal effort.
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DOI: 10.1097/MLG.0b013e31815acaf9
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Montequin</name><affiliation><mods:affiliation>The National Center for Voice and Speech, The Denver Center for the Performing Arts, Denver, Colorado, U.S.A.</mods:affiliation></affiliation></author><author><name sortKey="Welham, Nathan V" sort="Welham, Nathan V" uniqKey="Welham N" first="Nathan V." last="Welham">Nathan V. Welham</name><affiliation><mods:affiliation>From the Division of Otolaryngology–Head and Neck Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, U.S.A.</mods:affiliation></affiliation></author><author><name sortKey="Dailey, Seth H" sort="Dailey, Seth H" uniqKey="Dailey S" first="Seth H." last="Dailey">Seth H. 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Montequin</name><affiliation><mods:affiliation>The National Center for Voice and Speech, The Denver Center for the Performing Arts, Denver, Colorado, U.S.A.</mods:affiliation></affiliation></author><author><name sortKey="Welham, Nathan V" sort="Welham, Nathan V" uniqKey="Welham N" first="Nathan V." last="Welham">Nathan V. Welham</name><affiliation><mods:affiliation>From the Division of Otolaryngology–Head and Neck Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, U.S.A.</mods:affiliation></affiliation></author><author><name sortKey="Dailey, Seth H" sort="Dailey, Seth H" uniqKey="Dailey S" first="Seth H." last="Dailey">Seth H. Dailey</name><affiliation><mods:affiliation>From the Division of Otolaryngology–Head and Neck Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, U.S.A.</mods:affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j">The Laryngoscope</title><title level="j" type="abbrev">The Laryngoscope</title><idno type="ISSN">0023-852X</idno><idno type="eISSN">1531-4995</idno><imprint><publisher>John Wiley & Sons, Inc.</publisher><pubPlace>Hoboken, NJ</pubPlace><date type="published" when="2008-03">2008-03</date><biblScope unit="volume">118</biblScope><biblScope unit="issue">3</biblScope><biblScope unit="page" from="552">552</biblScope><biblScope unit="page" to="558">558</biblScope></imprint><idno type="ISSN">0023-852X</idno></series><idno type="istex">82DF71DF66A3703D210895B0C477A79467ED3804</idno><idno type="DOI">10.1097/MLG.0b013e31815acaf9</idno><idno type="ArticleID">LARY5541180331</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0023-852X</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Thyroplasty</term><term>arytenoid adduction</term><term>arytenopexy</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Hypothesis: Adduction arytenopexy (AP) with thyroplasty provides improved physiologic placement of the vocal fold and therefore provides improved acoustic, aerodynamic, and vibratory function as compared with arytenoid adduction (AA) with thyroplasty. Methods: Five cadaveric human larynges were prepared by removing supraglottic tissues and fixing the nontest vocal fold medially on the cricoid facet with a needle in a physiologic phonating position. Each test vocal fold was then sequentially tested using an excised larynx phonation system, first with AA with silastic medialization and then converted to AP without changing the contralateral fold position or silastic wedge. The excised larynx setup allowed for simultaneous collection of data, specifically subglottic pressure (including measurement of phonation threshold pressure [PTP]), mean airflow, acoustic output, and full‐frame high‐speed digital video. Results: Aerodynamic evaluation was similar for each group with similar subglottic pressure versus output curves. Conditions involving AP typically had PTP values that were 80% of that for comparable AA conditions. Acoustic evaluation revealed differences between the two groups. Each AA was found to be vibrating with two dominant frequencies with their associated harmonics. Each AP vibrated at a single dominant frequency with its harmonics. Conclusion: AP provides improved vocal outcomes by decreasing system noise and decreasing PTP, which may lead to a stronger glottal signal with decreased vocal effort.</div></front></TEI><istex><corpusName>wiley</corpusName><author><json:item><name>Justin McNamar MD</name><affiliations><json:string>From the Division of Otolaryngology–Head and Neck Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, U.S.A.</json:string></affiliations></json:item><json:item><name>Douglas W. Montequin PhD</name><affiliations><json:string>The National Center for Voice and Speech, The Denver Center for the Performing Arts, Denver, Colorado, U.S.A.</json:string></affiliations></json:item><json:item><name>Nathan V. Welham PhD</name><affiliations><json:string>From the Division of Otolaryngology–Head and Neck Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, U.S.A.</json:string></affiliations></json:item><json:item><name>Seth H. Dailey MD</name><affiliations><json:string>From the Division of Otolaryngology–Head and Neck Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, U.S.A.</json:string></affiliations></json:item></author><subject><json:item><lang><json:string>eng</json:string></lang><value>Thyroplasty</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>arytenoid adduction</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>arytenopexy</value></json:item></subject><articleId><json:string>LARY5541180331</json:string></articleId><language><json:string>eng</json:string></language><abstract>Hypothesis: Adduction arytenopexy (AP) with thyroplasty provides improved physiologic placement of the vocal fold and therefore provides improved acoustic, aerodynamic, and vibratory function as compared with arytenoid adduction (AA) with thyroplasty. Methods: Five cadaveric human larynges were prepared by removing supraglottic tissues and fixing the nontest vocal fold medially on the cricoid facet with a needle in a physiologic phonating position. Each test vocal fold was then sequentially tested using an excised larynx phonation system, first with AA with silastic medialization and then converted to AP without changing the contralateral fold position or silastic wedge. The excised larynx setup allowed for simultaneous collection of data, specifically subglottic pressure (including measurement of phonation threshold pressure [PTP]), mean airflow, acoustic output, and full‐frame high‐speed digital video. Results: Aerodynamic evaluation was similar for each group with similar subglottic pressure versus output curves. Conditions involving AP typically had PTP values that were 80% of that for comparable AA conditions. Acoustic evaluation revealed differences between the two groups. Each AA was found to be vibrating with two dominant frequencies with their associated harmonics. Each AP vibrated at a single dominant frequency with its harmonics. 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Dailey, K4/719 CSC, 600 Highland Avenue, Madison, WI 53792.</p></note><affiliation>From the Division of Otolaryngology–Head and Neck Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, U.S.A.</affiliation></author></analytic><monogr><title level="j">The Laryngoscope</title><title level="j" type="abbrev">The Laryngoscope</title><idno type="pISSN">0023-852X</idno><idno type="eISSN">1531-4995</idno><idno type="DOI">10.1002/(ISSN)1531-4995</idno><imprint><publisher>John Wiley & Sons, Inc.</publisher><pubPlace>Hoboken, NJ</pubPlace><date type="published" when="2008-03"></date><biblScope unit="volume">118</biblScope><biblScope unit="issue">3</biblScope><biblScope unit="page" from="552">552</biblScope><biblScope unit="page" to="558">558</biblScope></imprint></monogr><idno type="istex">82DF71DF66A3703D210895B0C477A79467ED3804</idno><idno type="DOI">10.1097/MLG.0b013e31815acaf9</idno><idno type="ArticleID">LARY5541180331</idno></biblStruct></sourceDesc></fileDesc><profileDesc><creation><date>2008</date></creation><langUsage><language ident="en">en</language></langUsage><abstract xml:lang="en"><p>Hypothesis: Adduction arytenopexy (AP) with thyroplasty provides improved physiologic placement of the vocal fold and therefore provides improved acoustic, aerodynamic, and vibratory function as compared with arytenoid adduction (AA) with thyroplasty. Methods: Five cadaveric human larynges were prepared by removing supraglottic tissues and fixing the nontest vocal fold medially on the cricoid facet with a needle in a physiologic phonating position. Each test vocal fold was then sequentially tested using an excised larynx phonation system, first with AA with silastic medialization and then converted to AP without changing the contralateral fold position or silastic wedge. The excised larynx setup allowed for simultaneous collection of data, specifically subglottic pressure (including measurement of phonation threshold pressure [PTP]), mean airflow, acoustic output, and full‐frame high‐speed digital video. Results: Aerodynamic evaluation was similar for each group with similar subglottic pressure versus output curves. Conditions involving AP typically had PTP values that were 80% of that for comparable AA conditions. Acoustic evaluation revealed differences between the two groups. Each AA was found to be vibrating with two dominant frequencies with their associated harmonics. Each AP vibrated at a single dominant frequency with its harmonics. Conclusion: AP provides improved vocal outcomes by decreasing system noise and decreasing PTP, which may lead to a stronger glottal signal with decreased vocal effort.</p></abstract><textClass xml:lang="en"><keywords scheme="keyword"><list><head>keywords</head><item><term>Thyroplasty</term></item><item><term>arytenoid adduction</term></item><item><term>arytenopexy</term></item></list></keywords></textClass><textClass><keywords scheme="Journal Subject"><list><head>article-category</head><item><term>Article</term></item></list></keywords></textClass></profileDesc><revisionDesc><change when="2007-09-10">Registration</change><change when="2008-03">Published</change></revisionDesc></teiHeader></istex:fulltextTEI><json:item><original>false</original><mimetype>text/plain</mimetype><extension>txt</extension><uri>https://api.istex.fr/document/82DF71DF66A3703D210895B0C477A79467ED3804/fulltext/txt</uri></json:item></fulltext><metadata><istex:metadataXml wicri:clean="Wiley, elements deleted: body"><istex:xmlDeclaration>version="1.0" encoding="UTF-8" standalone="yes"</istex:xmlDeclaration><istex:document><component version="2.0" type="serialArticle" xml:lang="en"><header><publicationMeta level="product"><publisherInfo><publisherName>John Wiley & Sons, Inc.</publisherName><publisherLoc>Hoboken, NJ</publisherLoc></publisherInfo><doi registered="yes">10.1002/(ISSN)1531-4995</doi><issn type="print">0023-852X</issn><issn type="electronic">1531-4995</issn><idGroup><id type="product" value="LARY"></id></idGroup><titleGroup><title type="main" xml:lang="en" sort="LARYNGOSCOPE">The Laryngoscope</title><title type="short">The Laryngoscope</title></titleGroup></publicationMeta><publicationMeta level="part" position="30"><doi origin="wiley" registered="no">10.1002/lary.v118:3</doi><numberingGroup><numbering type="journalVolume" number="118">118</numbering><numbering type="journalIssue">3</numbering></numberingGroup><coverDate startDate="2008-03">March 2008</coverDate></publicationMeta><publicationMeta level="unit" type="article" position="31" status="forIssue"><doi origin="wiley" registered="yes">10.1097/MLG.0b013e31815acaf9</doi><idGroup><id type="unit" value="LARY5541180331"></id></idGroup><countGroup><count type="pageTotal" number="7"></count></countGroup><titleGroup><title type="articleCategory">Article</title><title type="tocHeading1">Articles</title></titleGroup><copyright ownership="thirdParty">Copyright © 2008 The Triological Society</copyright><eventGroup><event type="manuscriptAccepted" date="2007-09-10"></event><event type="firstOnline" date="2009-01-02"></event><event type="publishedOnlineFinalForm" date="2009-01-02"></event><event type="xmlConverted" agent="Converter:JWSART34_TO_WML3G version:2.3.1 mode:FullText source:FullText result:FullText" date="2010-02-23"></event><event type="xmlConverted" agent="Converter:WILEY_ML3G_TO_WILEY_ML3GV2 version:3.8.8" date="2014-02-01"></event><event type="xmlConverted" agent="Converter:WML3G_To_WML3G version:4.1.7 mode:FullText,remove_FC" date="2014-11-04"></event></eventGroup><numberingGroup><numbering type="pageFirst">552</numbering><numbering type="pageLast">558</numbering></numberingGroup><correspondenceTo>Dr. Seth H. Dailey, K4/719 CSC, 600 Highland Avenue, Madison, WI 53792.</correspondenceTo><linkGroup><link type="toTypesetVersion" href="file:LARY.LARY5541180331.pdf"></link></linkGroup></publicationMeta><contentMeta><countGroup><count type="figureTotal" number="2"></count><count type="tableTotal" number="3"></count><count type="referenceTotal" number="16"></count></countGroup><titleGroup><title type="main" xml:lang="en">Aerodynamic, Acoustic, and Vibratory Comparison of Arytenoid Adduction and Adduction Arytenopexy</title><title type="short" xml:lang="en">Aerodynamic, Acoustic, and Vibratory Comparison of Arytenoid Adduction and Adduction Arytenopexy</title></titleGroup><creators><creator xml:id="au1" creatorRole="author" affiliationRef="#af1"><personName><givenNames>Justin</givenNames><familyName>McNamar</familyName><degrees>MD</degrees></personName></creator><creator xml:id="au2" creatorRole="author" affiliationRef="#af2"><personName><givenNames>Douglas W.</givenNames><familyName>Montequin</familyName><degrees>PhD</degrees></personName></creator><creator xml:id="au3" creatorRole="author" affiliationRef="#af1"><personName><givenNames>Nathan V.</givenNames><familyName>Welham</familyName><degrees>PhD</degrees></personName></creator><creator xml:id="au4" creatorRole="author" affiliationRef="#af1" corresponding="yes"><personName><givenNames>Seth H.</givenNames><familyName>Dailey</familyName><degrees>MD</degrees></personName><contactDetails><email>dailey@surgery.wisc.edu</email></contactDetails></creator></creators><affiliationGroup><affiliation xml:id="af1" countryCode="US" type="organization"><unparsedAffiliation>From the Division of Otolaryngology–Head and Neck Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, U.S.A.</unparsedAffiliation></affiliation><affiliation xml:id="af2" countryCode="US" type="organization"><unparsedAffiliation>The National Center for Voice and Speech, The Denver Center for the Performing Arts, Denver, Colorado, U.S.A.</unparsedAffiliation></affiliation></affiliationGroup><keywordGroup xml:lang="en" type="author"><keyword xml:id="kwd1">Thyroplasty</keyword><keyword xml:id="kwd2">arytenoid adduction</keyword><keyword xml:id="kwd3">arytenopexy</keyword></keywordGroup><abstractGroup><abstract type="main" xml:lang="en"><title type="main">Abstract</title><p><b>Hypothesis:</b> Adduction arytenopexy (AP) with thyroplasty provides improved physiologic placement of the vocal fold and therefore provides improved acoustic, aerodynamic, and vibratory function as compared with arytenoid adduction (AA) with thyroplasty.</p><p><b>Methods:</b> Five cadaveric human larynges were prepared by removing supraglottic tissues and fixing the nontest vocal fold medially on the cricoid facet with a needle in a physiologic phonating position. Each test vocal fold was then sequentially tested using an excised larynx phonation system, first with AA with silastic medialization and then converted to AP without changing the contralateral fold position or silastic wedge. The excised larynx setup allowed for simultaneous collection of data, specifically subglottic pressure (including measurement of phonation threshold pressure [PTP]), mean airflow, acoustic output, and full‐frame high‐speed digital video.</p><p><b>Results:</b> Aerodynamic evaluation was similar for each group with similar subglottic pressure versus output curves. Conditions involving AP typically had PTP values that were 80% of that for comparable AA conditions. Acoustic evaluation revealed differences between the two groups. Each AA was found to be vibrating with two dominant frequencies with their associated harmonics. Each AP vibrated at a single dominant frequency with its harmonics.</p><p><b>Conclusion:</b> AP provides improved vocal outcomes by decreasing system noise and decreasing PTP, which may lead to a stronger glottal signal with decreased vocal effort.</p></abstract></abstractGroup></contentMeta></header></component></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>Aerodynamic, Acoustic, and Vibratory Comparison of Arytenoid Adduction and Adduction Arytenopexy</title></titleInfo><titleInfo type="abbreviated" lang="en"><title>Aerodynamic, Acoustic, and Vibratory Comparison of Arytenoid Adduction and Adduction Arytenopexy</title></titleInfo><titleInfo type="alternative" contentType="CDATA" lang="en"><title>Aerodynamic, Acoustic, and Vibratory Comparison of Arytenoid Adduction and Adduction Arytenopexy</title></titleInfo><name type="personal"><namePart type="given">Justin</namePart><namePart type="family">McNamar</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>From the Division of Otolaryngology–Head and Neck Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, U.S.A.</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Douglas W.</namePart><namePart type="family">Montequin</namePart><namePart type="termsOfAddress">PhD</namePart><affiliation>The National Center for Voice and Speech, The Denver Center for the Performing Arts, Denver, Colorado, U.S.A.</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Nathan V.</namePart><namePart type="family">Welham</namePart><namePart type="termsOfAddress">PhD</namePart><affiliation>From the Division of Otolaryngology–Head and Neck Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, U.S.A.</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Seth H.</namePart><namePart type="family">Dailey</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>From the Division of Otolaryngology–Head and Neck Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, U.S.A.</affiliation><description>Correspondence: Dr. Seth H. Dailey, K4/719 CSC, 600 Highland Avenue, Madison, WI 53792.</description><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="article" displayLabel="article"></genre><originInfo><publisher>John Wiley & Sons, Inc.</publisher><place><placeTerm type="text">Hoboken, NJ</placeTerm></place><dateIssued encoding="w3cdtf">2008-03</dateIssued><dateValid encoding="w3cdtf">2007-09-10</dateValid><copyrightDate encoding="w3cdtf">2008</copyrightDate></originInfo><language><languageTerm type="code" authority="rfc3066">en</languageTerm><languageTerm type="code" authority="iso639-2b">eng</languageTerm></language><physicalDescription><internetMediaType>text/html</internetMediaType><extent unit="figures">2</extent><extent unit="tables">3</extent><extent unit="references">16</extent></physicalDescription><abstract lang="en">Hypothesis: Adduction arytenopexy (AP) with thyroplasty provides improved physiologic placement of the vocal fold and therefore provides improved acoustic, aerodynamic, and vibratory function as compared with arytenoid adduction (AA) with thyroplasty. Methods: Five cadaveric human larynges were prepared by removing supraglottic tissues and fixing the nontest vocal fold medially on the cricoid facet with a needle in a physiologic phonating position. Each test vocal fold was then sequentially tested using an excised larynx phonation system, first with AA with silastic medialization and then converted to AP without changing the contralateral fold position or silastic wedge. The excised larynx setup allowed for simultaneous collection of data, specifically subglottic pressure (including measurement of phonation threshold pressure [PTP]), mean airflow, acoustic output, and full‐frame high‐speed digital video. Results: Aerodynamic evaluation was similar for each group with similar subglottic pressure versus output curves. Conditions involving AP typically had PTP values that were 80% of that for comparable AA conditions. Acoustic evaluation revealed differences between the two groups. Each AA was found to be vibrating with two dominant frequencies with their associated harmonics. Each AP vibrated at a single dominant frequency with its harmonics. Conclusion: AP provides improved vocal outcomes by decreasing system noise and decreasing PTP, which may lead to a stronger glottal signal with decreased vocal effort.</abstract><subject lang="en"><genre>keywords</genre><topic>Thyroplasty</topic><topic>arytenoid adduction</topic><topic>arytenopexy</topic></subject><relatedItem type="host"><titleInfo><title>The Laryngoscope</title></titleInfo><titleInfo type="abbreviated"><title>The Laryngoscope</title></titleInfo><genre type="journal">journal</genre><subject><genre>article-category</genre><topic>Article</topic></subject><identifier type="ISSN">0023-852X</identifier><identifier type="eISSN">1531-4995</identifier><identifier type="DOI">10.1002/(ISSN)1531-4995</identifier><identifier type="PublisherID">LARY</identifier><part><date>2008</date><detail type="volume"><caption>vol.</caption><number>118</number></detail><detail type="issue"><caption>no.</caption><number>3</number></detail><extent unit="pages"><start>552</start><end>558</end><total>7</total></extent></part></relatedItem><identifier type="istex">82DF71DF66A3703D210895B0C477A79467ED3804</identifier><identifier type="DOI">10.1097/MLG.0b013e31815acaf9</identifier><identifier type="ArticleID">LARY5541180331</identifier><accessCondition type="use and reproduction" contentType="copyright">Copyright © 2008 The Triological Society</accessCondition><recordInfo><recordContentSource>WILEY</recordContentSource><recordOrigin>John Wiley & Sons, Inc.</recordOrigin></recordInfo></mods></metadata><serie></serie></istex></record>Pour manipuler ce document sous Unix (Dilib)
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